SC State Health Department

To: Dr. Galloway, Director of Office of Injury Prevention

From: Kathryn Witt, Research Assistant Office of Injury Prevention

Date: October 15, 2019

Re: Preventing unintentional drownings in 1-4 year olds

Unintentional injuries are extremely preventable; however, they remain to be one of the
leading causes of death in the United States and, more specifically, South Carolina.
According to the National Center for Health Statistics (NCHS), in 2016, accidents
(unintentional injuries) were the third leading cause of death for all races and origins,
both sexes, and all ages in the US. NCHS reported the mortality rate for unintentional
injuries in the US in 2016 was 49.9 deaths per 100,000 population. These statistics hold
true for South Carolina as well where unintentional injuries were also ranked 3 rd for
causes of death in 2016, according to the South Carolina Department of Health and
Environmental Control (SCDHEC). SCDEHC also reported that the mortality rate for
unintentional injuries in South Carolina in 2016 was 60.4 deaths per 100,000 population
which is significantly higher than the US unintentional injury mortality rate. The purpose
of this memorandum is to highlight deaths due to unintentional injuries, specifically
unintentional drownings in 1-4 year olds, and discuss preventative strategies.

In 2016, SCDHEC reported that accidents were the leading cause of death in 1-4 year
olds, accounting for 36.6% of all deaths. At the national level, the top three causes of
accident-related deaths in 1-4 year olds in 2016 were drownings, motor-vehicle
accidents, and suffocation, in that order. Unintentional drownings accounted for 425
deaths in children aged 1-4 in 2016, according to NCHS. Children of the ages 1-4 have
the highest rate of unintentional drownings compared to all other age groups. The
National Center for Injury Prevention and Control (NCIPC) cited that about ten people
die daily from unintentional drowning, two of these are children aged 14 or younger.

Unintentional drownings are both predictable and preventable. Risk factors and
conditions include age, gender, lack of supervision, lack of pool fencing, inability to
swim, failure to wear flotation devices, etc. According to NCIPC, most drownings in
children aged 1-4 occur in home swimming pools. NCIPC also reported that African
Americans have a significantly higher rate of unintentional drownings than whites across
all age groups. To ensure safety at home, home owners with a swimming pool in SC
should be required by law to install a pool fence to create a barrier around the
swimming area. In addition, home owners with a pool should be encouraged to install
alarms on the fence to alert them when someone enters the pool area. This would help
to prevent children from accessing the pool without adult supervision. Emphasizing the
importance of formal swimming lessons in school-aged children can decrease the risk of
drowning in children aged 1-4. Children are encouraged to begin learning to swim once
they are age 4 or older. In public swimming areas, young children who are unable to
swim should be required to wear flotation devices or swim with a parent/guardian.
Drownings can occur very quickly which is why it is always important that a
parent/guardian is closely supervising. According to NCIPC, CPR performed by
bystanders improves the outcomes of drowning victims which emphasizes the
significance of learning CPR, especially for parents and caretakers. Pre-schools and
elementary schools in South Carolina should offer after-school CPR classes for parents
and children. This would be an opportunity for parents and children to learn CPR
together and would benefit all parties.

Unintentional injuries were the third leading cause of death in both the United States
and South Carolina in 2016. The leading cause of death in children 1-4 years old is
unintentional drownings. Children ages 1-4 have the highest rate of drownings when
compared to all other age groups which is why it is important to highlight the risk factors.
Most of these drownings occur in home swimming pools which is why it is important for
home owners to install both pool fences and alarm systems to prevent young children

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from accessing the pool area without supervision. In addition, once children are of a
capable age, they should receive formal swimming lessons to decrease the risk of
drowning. It is also important for parents and caretakers of 1-4 year olds to know how to
preform CPR in the case a drowning occurs. I would love to meet with you to discuss
the information and suggestions presented in this memorandum.